General practitioner contacts, hospitalizations, and nursing home transfers in older patients up to three years after new cancer diagnosis: Results from a large data linkage cohort study.
Authors: Victoria Depoorter, Katrijn Vanschoenbeek, Lore Decoster, Harlinde De Schutter, Philip R. Debruyne, Inge DeGroof, Dominique Bron, Frank Cornélis, Sylvie Luce, C. N. J. Focan, Vincent Verschaeve, Gwenaelle Debugne, Christine M. L. H. Langenaeken, Heidi Van Den Bulck, Jean-Charles Goeminne, Koen Milisen, Johan Flamaing, Cindy Kenis, Freija Verdoodt, Hans Wildiers
Journal: Journal of Clinical Oncology (2022)

12041 Background: Long-term outcomes after cancer diagnosis in older persons are largely unexplored because of limited follow-up in clinical studies. By linking clinical data with population-based data, studying long-term outcomes in large cohorts becomes feasible. The current study aims to explore long-term outcomes in the care trajectory of older patients with cancer and to assess their association with baseline geriatric screening and assessment (GS/GA) results. Methods: A large cohort study of older patients with a new cancer diagnosis was set up by linking clinical, cancer registry and administrative health data based on a unique patient identifier. Clinical data were derived from a previously performed prospective multicentric Belgian study (2009-2015). Patients aged ≥ 70 years were screened with G8 followed by GA in case of an abnormal result (≤14/17). Tumor characteristics and vital status were derived from cancer registry data and long-term outcomes (general practitioner (GP) contacts, hospitalizations and nursing home transfers) from administrative health data. In patients that survived at least 3 months since inclusion, outcomes were assessed from the day after inclusion until 3 years after. Event rates were calculated using person-time at risk to allow for varying follow-up time. Patients were censored 3 months before death to exclude influence of end-of-life care. Results: After data linkage, 6,391 older patients with a new cancer diagnosis were available for this analysis. The median age was 77 (range: 70–100) and 59.8% was female. Diagnoses included solid (92.8%) and hematologic malignancies (7.2%). In the patients with a solid tumor, breast, colorectal and lung cancer were the most common and 20.1% of patients had stage IV. 64.3% of patients had an abnormal baseline G8 score. During the 3 year follow-up, 2,602 (40.7%) of the included patients died. In these 3 years, 5,985 (95.2%) patients had at least one contact with a GP and 4,634 (72.5%) had at least one new hospital admission (event rates in Table 1). Of the 3,724 patients living independently at inclusion and still alive after 3 years, 281 (7.5%) had been transferred to a nursing home and of those, 240 (85.4%) patients had an abnormal baseline G8 score. Conclusions: Older patients with an abnormal baseline G8 score have more GP contacts, hospital admissions and nursing home transfers in the 3 years following a new cancer diagnosis compared to patients with normal baseline G8 score. Baseline G8 could help identify patients at risk for higher long-term healthcare utilization.[Table: see text]